Pennsylvania faces a self-inflicted health care crisis for kids

Having dedicated my career to making health care coverage accessible to all Pennsylvanians, I am dismayed over recent actions by the state that are jeopardizing health care access for children.

The number of Pennsylvania children covered through Medicaid has plummeted by about 89,000 in recent months, including many kids with life-threatening medical needs who were hastily — and wrongly — cut from Medicaid despite meeting the eligibility requirements.

Those wrongly dropped from Medicaid included a 5-year-old undergoing treatments for leukemia and an infant with congenital heart deformities. They also include a severely disabled 12-year-old who requires home health care and a pair of 9-year-old twins — one diagnosed with autism, the other with a hearing impairment — who rely on Medicaid to provide supports and services critical to their development and learning.

Many of these children rely on Medicaid not only for physical health services, but also critical behavioral health services that help them get by day to day. To understand how this happened and how we can fix it requires a quick history of the health care coverage crisis that has been quietly unfolding in Pennsylvania since last summer.

Last August, the Department of Public Welfare began sending out hundreds of thousands of renewal notices to Pennsylvania families receiving Medicaid, allowing these families 10 to 15 days to provide documentation to keep their children enrolled in Medicaid.

If DPW did not receive and process all requested paperwork within this 10 to 15-day deadline, the child was dropped from Medicaid, even if the deadline was missed due to DPW’s own bureaucratic backlogs.

Locally, this poorly planned process cut off Medicaid to more than 2,000 children in Dauphin County, nearly 1,600 in York County and more than 2,500 in Lancaster County. There’s another troubling aspect to this story: Families whose children are no longer income eligible for Medicaid are referred to the Children’s Health Insurance Program, or CHIP, yet we have not seen an increase in CHIP enrollment that corresponds to the drastic Medicaid enrollment decline.

In a state with near universal coverage for children, where have these children gone?
And what can be done to ensure these children, and others, are not put at risk due to lack of access to health care?

Part of the solution lies in the Affordable Care Act. Look beyond the heated political rhetoric and it’s easy to see how the ACA is helping to keep young Pennsylvanians healthy at a time when our state policies are putting children’s health care at risk.

More than 1.1 million Pennsylvania children are benefiting from the ACA’s prohibition on lifetime limits on health care. Insurance companies can no longer deny coverage for children in Pennsylvania with pre-existing conditions, and nearly 65,000 young adults can now remain on a parent’s health insurance coverage up to age 26.

Why should any of this matter to Pennsylvanians who don’t have kids? Because we all benefit, financially and otherwise, when children are healthy. Healthy kids grow up to be healthy adults. Families are less likely to put off medical care for their children and run the risk of needing more costly and complicated medical treatments later.

George Hoover

Fortunately, Gov. Tom Corbett has embraced a critical aspect of the ACA that state lawmakers should support, too. The state is moving ahead with plans to create a health insurance exchange, a user-friendly, online insurance marketplace, that will enable all families with children to obtain and maintain high-quality health insurance in a streamlined way.

If we do it right, Pennsylvania’s exchange will allow children to have access to the behavioral and physical health benefits they need to be healthy. The governor and General Assembly should enact necessary legislation this spring to get the exchange up and running.

The commonwealth has been a national leader in providing affordable, accessible, quality health care coverage for children through Medicaid, CHIP and Cover All Kids — efforts that have been supported by governors and lawmakers of both parties for over two decades.

The ACA helps us build on those efforts, and it does so at a critical time when we have seen children’s access to health care jeopardized through shortsighted policies at the state level.

George Hoover is the health policy director for Pennsylvania Partnerships for Children. He has nearly 40 years of experience in human services, including serving as a deputy commissioner in the Pennsylvania Insurance Department, where he oversaw the Children’s Health Insurance Program.